<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-1146</journal-id>
<journal-title><![CDATA[Boletín médico del Hospital Infantil de México]]></journal-title>
<abbrev-journal-title><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></abbrev-journal-title>
<issn>1665-1146</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-11462025000200004</article-id>
<article-id pub-id-type="doi">10.24875/bmhim.24000091</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Effectiveness and safety of topical sirolimus in children with angiofibromas and tuberous sclerosis complex]]></article-title>
<article-title xml:lang="es"><![CDATA[Efectividad y seguridad del sirolimus tópico en niños con angiofibromas y complejo de esclerosis tuberosa]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández de Lara-Arrieta]]></surname>
<given-names><![CDATA[Andrea]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-de La Puente]]></surname>
<given-names><![CDATA[Silvestre]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Flores-Pérez]]></surname>
<given-names><![CDATA[Janett]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Flores-Pérez]]></surname>
<given-names><![CDATA[Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lomelí-Valdez]]></surname>
<given-names><![CDATA[Rodrigo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Venegas-Andrade]]></surname>
<given-names><![CDATA[Andrea]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Palacios-López]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Mexico City  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Pediatría Department of Research Methodology ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional de Pediatría Department of Pharmacology ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Nacional de Pediatría Department of Dermatology ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<volume>82</volume>
<numero>2</numero>
<fpage>115</fpage>
<lpage>120</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-11462025000200004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-11462025000200004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-11462025000200004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Tuberous sclerosis complex (TSC) is an autosomal dominant disease that can affect any organ with hamartomas. It is characterized by early-onset seizures and is associated with intellectual disability. The main dermatological findings include hypopigmented macules, shagreen patches, and angiofibromas, which appear in 81-96% of patients.  Method: We conducted a quasi-experimental, before-and-after, open-label study in 10 patients with TSC and facial angiofibromas, aged 8-17 years, who were treated at the dermatology service of the Instituto Nacional de Pediatría in 2019 and 2020. All patients agreed to participate in the study and signed both consent and assent forms. All patients received treatment with 1% topical sirolimus for 6 months on the right side of the face, followed by 6 months on the left side of the face to assess recurrence. Each patient served as their own control. Measurements of baseline lesions were taken and followed monthly for 6 months. The changes in lesion size, measured in millimeters at each time point, were compared using repeated measures analysis of variance.  Results: All children showed a decrease in the size and number of angiofibromas, as well as reduced erythema, from the 3rd month of treatment. Few recurrences were observed beginning at 4 months after discontinuation of the medication.  Conclusion: Topical sirolimus is effective and safe for treating patients with angiofibromas and TSC.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: El complejo esclerosis tuberosa (CET) es una enfermedad autosómica dominante y puede dañar cualquier órgano con hamartomas. Se caracteriza por inicio temprano de crisis convulsivas y se asocia con discapacidad intelectual. Los principales hallazgos dermatológicos incluyen las manchas hipopigmentadas lanceoladas, placas de Shagreen, y los angiofibromas, que aparecen del 81 al 96% de los pacientes.  Método: Realizamos un estudio cuasi experimental, de antes y después, de etiqueta abierta, en 10 pacientes con CET y angiofibromas, en cara, de 8-17 años, que fueron atendidos en el servicio de Dermatología del Instituto Nacional de Pediatría, durante 2019 y 2020. Los pacientes aceptaron participar en el estudio y firmaron carta de consentimiento y asentimiento informado.Todos ellos recibieron tratamiento con sirolimus tópico al 1%, 6 meses en el lado derecho de la cara, y 6 meses en el lado izquierdo de la cara; para valorar recidivas, se tomó como control al mismo paciente. Se realizaron mediciones de las lesiones basales y cada mes durante 6 meses. El cambio en el tamaño de las lesiones (en mm) en cada medición, se comparó mediante ANOVA de mediciones repetidas.  Resultados: Todos los pacientes presentaron disminución del tamaño, número de angiofibromas y eritema a partir del tercer mes de tratamiento, y se presentaron pocas recidivas a partir del cuarto mes de suspender el medicamento.  Conclusiones: El sirolimus tópico es eficaz y seguro para tratar a los pacientes con angiofibromas y CET.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Tuberous sclerosis]]></kwd>
<kwd lng="en"><![CDATA[Angiofibromas]]></kwd>
<kwd lng="en"><![CDATA[Sirolimus]]></kwd>
<kwd lng="en"><![CDATA[Children]]></kwd>
<kwd lng="es"><![CDATA[Esclerosis tuberosa]]></kwd>
<kwd lng="es"><![CDATA[Angiofibromas]]></kwd>
<kwd lng="es"><![CDATA[Sirolimus]]></kwd>
<kwd lng="es"><![CDATA[Niños]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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